QUESTIONS 

AND ANSWERS 

ABOUT

TUBERCULOSIS

2021
TUBERCULOSIS

UESTIONS

ABOUT

2021

& NSWERS

Questions and Answers About Tuberculosis (TB) provides information 

on the diagnosis and treatment of TB infection and TB disease. Key 

audiences for this booklet are people with or at risk for TB; people 

who may have been exposed to someone with TB; people who 

provide services for those at high risk for TB, such as correctional 

officers, homeless shelter workers, and emergency responders; and 

people who want to learn more about tuberculosis. For additional 

information on TB, please visit the CDC TB website.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

Division of Tuberculosis Elimination
TABLE OF CONTENTS

What is TB? 

Why is TB still a problem in the United States?  

How is TB spread? 

Who is at risk for getting TB? 

What is latent TB infection (LTBI)? 

What is TB disease?  

Who is at risk for TB disease? 

What are the symptoms of TB disease? 

What is the difference between latent TB infection (LTBI) and TB disease?  

Should I get tested for TB? . 

What are the tests for TB infection? . 

What if I have a positive test for TB infection? . 

What if I have been vaccinated with bacille Calmette-Guérin (BCG)? . 

If I have latent TB infection (LTBI), how can I avoid developing TB disease? . 

What are the side effects of medicines to treat latent TB infection (LTBI)? . 

What if I have HIV infection? . 

If I was exposed to someone with TB disease, can I give TB to others? . 

How is TB disease treated? . 

What are the side effects of TB disease medicines? . 

Why do I need to take TB medicines for so long? . 

What are multidrug-resistant TB (MDR TB) and extensively drug-resistant TB (XDR TB)? . 

What is directly observed therapy (DOT)? . 

How can I remember to take my TB medicines if I am not on DOT? . 

How can I keep from spreading TB? . 

Additional TB Resources . 
What is TB?

Tuberculosis (TB) is caused by bacteria called Mycobacterium tuberculosis (M. 

tuberculosis). The bacteria, or germs, usually attack the lungs. TB germs can attack 

any part of the body, such as the kidney, spine, or brain. 

There is good news. People with TB can be treated if they seek medical help. 

Why is TB still a problem in the United States?

TB is preventable and treatable but remains the world’s deadliest infectious-disease 

killer. Having infectious TB disease means that you can spread TB germs to others. In 

the last several years, the United States has reported the lowest number of TB cases 

on record, but too many people still suffer from TB. Even with decreasing numbers, 

TB continues to be a problem. While the number of TB cases in the United States 

has gone down, TB rates are still higher among persons in racial and ethnic minority 

groups compared with White persons. This is because certain racial and ethnic groups 

are more likely to have TB risk factors that can increase the chance of developing the 

disease (see page 7).

This booklet answers common questions about TB. Please ask your doctor, nurse, or 

other health care provider if you have additional questions.

How is TB spread?

TB is spread through the air from one person to another. The TB germs are spread into 

the air when a person with infectious TB disease of the lungs or throat coughs, speaks, 

or sings. People nearby may breathe in these TB germs and become infected. 

When a person breathes in 

TB germs, the TB germs 

can settle in the lungs 

and begin to grow. From 

there, the TB germs can 

move through the blood 

to other parts of the 

body, such as the 

kidney, spine, 

or brain. 

Q&A ABOUT TB 4
Who is at risk for getting TB?

Anyone can get TB. Some people have a higher risk of getting infected with TB:

» People who have contact with someone who has infectious TB disease

People who were born in or who frequently travel to countries where TB disease 

is common, including Mexico, the Philippines, Vietnam, India, China, Haiti, 

Guatemala, and other countries with high rates of TB 

Health care workers and others who work or live in places at high risk for TB 

transmission, such as homeless shelters, jails, and nursing homes

What is latent TB infection (LTBI)?

In most people who breathe in TB germs and become infected, the body is able to 

fight the TB germs to stop them from growing. The TB germs become inactive, but 

they remain alive in the body and can become active later. This is called latent TB 

infection, or LTBI for short.

People with LTBI

» Have no symptoms.

Don’t feel sick.

Can’t spread TB germs to others.

Will usually have a positive TB blood test or positive TB skin test reaction. 

May develop TB disease if they do not receive treatment for LTBI (see page 13).

People with LTBI do not have symptoms, and they cannot spread TB germs to others. 

However, if TB germs become active in the body and multiply, the person will go from 

having LTBI to being sick with TB disease. For this reason, people with LTBI should be 

treated to prevent them from developing TB disease. Treatment of LTBI is essential to 

controlling TB in the United States because it substantially reduces the risk that LTBI 

will progress to TB disease.

Q&A ABOUT TB 5
What is TB disease?

If the immune system can’t stop TB germs from growing, the TB germs begin to 

multiply in the body and cause TB disease. The TB germs attack the body, and if this 

occurs in the lungs, the TB germs can create a hole in the lung. Some people develop 

TB disease soon after becoming infected (within weeks) before their immune system 

can fight the TB germs. Other people have latent TB infection and may get sick years 

later, when their immune system becomes weak for another reason. Treating latent TB 

infection (LTBI) is effective in preventing TB disease. 

People with TB disease in the lungs or throat can be infectious, meaning that they can 

pass TB germs to their family, friends, and others around them. People with TB in other 

parts of their bodies, such as the kidneys or spine, are usually not infectious.

People with TB disease are most likely to spread TB germs to people they spend time 

with every day. This includes family members, friends, coworkers, or schoolmates.

People with TB disease need to take several medicines when they start treatment. 

After taking TB medicine for several weeks, a doctor will be able to tell TB patients 

when they are no longer able to spread TB germs to others. Most people with TB 

disease will need to take TB medicine for at least 6 months to be cured.

Q&A ABOUT TB 6
Who is at risk for TB disease?

Many people who have latent TB infection (LTBI) never develop TB disease. While 

not everyone with LTBI will develop TB disease, about 5–10% will develop TB disease 

over their lifetimes if not treated. Progression from untreated LTBI to TB disease is 

estimated to account for approximately 80% of U.S. TB cases. Some people who 

have LTBI are more likely to develop TB disease than others. People at high risk for 

developing TB disease generally fall into two categories:

1. Those who have been recently infected with TB germs

2. Those with medical conditions that weaken the immune system including:

» HIV infection 

Substance use (such as injection drug use) 

Specialized treatment for rheumatoid arthritis or Crohn’s disease

Organ transplants

Severe kidney disease

Head and neck cancer

Diabetes

Medical treatments such as corticosteroids 

Silicosis 

Low body weight

Children, especially those under age 5, have a higher risk of developing TB disease 

once infected. 

Q&A ABOUT TB 7
What are the symptoms of TB disease?

Symptoms of TB disease depend on where in the body the TB germs are growing. TB 

disease in the lungs may cause the following symptoms:

»Cough 

(lasting longer 

than 3 weeks)

Coughing up blood or 

sputum (phlegm from 

inside the lungs) 

»Chest pain

»Fever »Night sweats »Chills

»Loss of appetite »Weakness or fatigue »Weight loss

Symptoms of TB disease in other parts of the body may include the following:

» TB of the kidney may cause blood in the urine.

TB meningitis may cause headache or confusion.

TB of the spine may cause back pain.

TB of the larynx may cause hoarseness.

For information on how TB disease is treated, see page 17.

Q&A ABOUT TB 8
What is the difference between latent TB infection 

(LTBI) and TB disease?

There are important differences between latent TB infection (LTBI) and TB disease. 

Knowing the differences can help you understand what to expect if you have LTBI or 

TB disease. The table below explains these key differences side by side.

A Person with Latent 

TB Infection (LTBI)

A Person with 

TB Disease

Has a small amount of TB germs in his/

her body that are alive but inactive

Has a large amount of active TB germs 

in his/her body

Has no symptoms Has symptoms that may include

» a bad cough that lasts 3 weeks or 

longer

pain in the chest

coughing up blood or sputum

weakness or fatigue

weight loss

no appetite

chills

fever

sweating at night

Cannot spread TB germs to others May spread TB germs to others

Does not feel sick May feel sick and may have symptoms 

such as a cough, fever, and/or weight 

loss

Usually has a positive TB skin test or TB 

blood test indicating TB infection

Usually has a positive TB skin test or TB 

blood test indicating TB infection 

Has a normal chest x-ray and a negative 

sputum smear

May have an abnormal chest x-ray, or 

positive sputum smear or culture

Should consider treatment for LTBI to 

prevent TB disease

Needs treatment for TB disease

TB

TB

TB

TB

TB

TB

TB

TB

TB

TB

TB TB

TB

TB

TB

TB TB

TB

TB TB

TB

TB

TB

TBTB

TB

Q&A ABOUT TB 9
Should I get tested for TB?

You should get tested for TB if:

» You have spent time with a person known or thought to have infectious TB 

disease.

You were born in or frequently travel to countries where TB disease is common, 

including Mexico, the Philippines, Vietnam, India, China, Haiti, and Guatemala, and 

other countries where TB is common.

You currently live, used to live, or are employed in a large group setting where TB 

is more common, such as a homeless shelter, prison, jail, or nursing home.

You are a health care worker who cares for patients with TB disease. 

You are part of a population that is more likely to have latent TB infection (LTBI) 

or TB disease, including people who don’t have good access to health care, have 

lower income, or misuse drugs or alcohol. 

In addition, children, especially those under 5, have a higher risk of developing TB 

disease once infected. Therefore, testing for TB infection in children who may have 

been exposed to a person with TB disease is important. 

What are the tests for TB infection?

There are two types of tests for TB infection: the TB blood test and the TB skin test. 

Your health care provider should choose which TB test to use. Factors in selecting 

which test to use include the reason for testing, test availability, and cost. Health care 

providers are encouraged to use newer TB blood tests to screen for TB infection. 

Generally, it is not necessary to use both a TB skin test and a TB blood test to test the 

same person.

TB Blood Tests

TB blood tests use a blood sample to find out if you are infected with TB germs. 

Two TB blood tests are approved by the U.S. Food and Drug Administration and are 

available in the United States:

» QuantiFERON®-TB Gold Plus (QFT-Plus)

T-SPOT®.TB test (T-Spot)

Q&A ABOUT TB 10
You can get a TB blood test at the health department or at your doctor’s office. The 

health care provider will draw your blood and send it to a laboratory for analysis and 

results. If your health department uses a TB blood test, only one visit is required to 

draw blood for the test.

+ Positive TB blood test: This means that you have been infected with TB 

germs. Additional tests are necessary to determine whether you have 

latent TB infect (LTBI) or TB disease. 

- Negative TB blood test: This means that your blood did not react to the 

test and that you likely do not have TB infection. 

TB blood tests are the recommended TB test for:

» People who have received the bacille Calmette–Guérin (BCG) TB vaccine.

People who have a difficult time returning for a second appointment to look for a 

reaction to the TB skin test.

TB Skin Test

The TB skin test may be used to find out if you are infected with TB germs. You can 

get a skin test at the health department or at your doctor’s office. A health care worker 

will inject a small amount of testing fluid (called tuberculin or PPD) into the skin on the 

lower part of your arm. After 2 or 3 days, you must return to have your skin test read 

by the health care worker. You may have swelling where the tuberculin was injected. 

The health care worker will measure this swelling and tell you if your reaction to the 

test is positive or negative. 

+ Positive skin test: This means the person’s body is infected with TB 

germs. Additional tests are needed to determine if the person has LTBI or 

TB disease.

- Negative skin test: This means the person’s body did not react to the test, 

and that LTBI or TB disease is not likely.

If your exposure to TB germs was recent, your TB skin test reaction may not be 

positive yet. You may need a second skin test 8 to 10 weeks after the last time you 

spent time with the person with TB disease. This is because it can take several weeks 

after infection for your immune system to react to the TB skin test. If your reaction to 

the second test is negative, you probably do not have TB infection.

Q&A ABOUT TB 11
What if I have a positive test for TB infection?

If you have a positive reaction to the TB blood test or TB skin test, your doctor or 

nurse will do other tests to see if you have TB disease. These tests usually include a 

chest x-ray. They may also include a test of the sputum you cough up. Because TB 

germs may be found somewhere other than your lungs, your doctor or nurse may 

check your urine, take tissue samples, or do other tests. Without treatment, latent TB 

infection (LTBI) can progress to TB disease. If you have LTBI, you should be treated 

to prevent TB disease (see page 13). If you have TB disease, you will need to take 

medicine to treat the disease (see page 17). 

What if I have been vaccinated with bacille CalmetteGuérin (BCG)?

BCG is a vaccine for TB. This vaccine is not widely used in the United States. Many 

people born outside of the United States have received the BCG TB vaccine.

It is often given to infants and small children in other countries where TB is more 

common. It protects children in those countries from getting severe forms of TB 

disease, such as TB meningitis. The BCG TB vaccine is not thought to protect people 

from getting TB disease in the lungs, which is the most common form of disease in the 

United States.

In some people, BCG TB vaccine may cause a positive TB skin test when they are 

not infected with TB germs. However, there is no way to know if a positive skin test 

reaction is caused by BCG vaccination or caused by true TB infection. 

When using the skin test, people who have been vaccinated with BCG 

and who have a positive skin test reaction should always be further 

evaluated for TB disease as if they were not vaccinated with BCG. 

Unlike the TB skin test, TB blood tests are not affected by 

prior BCG vaccination. Therefore, TB blood tests are the 

preferred test for people who have received the BCG 

vaccine.

BCG

Q&A ABOUT TB 12
If I have latent TB infection (LTBI), how can I avoid 

developing TB disease?

Without treatment, latent TB infection (LTBI) can progress to TB disease. If you 

have LTBI, you should be treated to prevent TB disease even if you do not feel sick. 

Treatment of LTBI is essential to preventing TB because it substantially reduces the 

risk that LTBI will progress to TB disease.

Treating LTBI is effective in preventing TB disease. There are several options for 

the treatment of LTBI. There have been advances in shortening the length of LTBI 

treatment from 6–9 months to 3–4 months. Short-course LTBI treatments are effective, 

are safe, and have higher completion rates than longer treatments.

If you have LTBI and you are in a high-risk group (see page 7), it is even more urgent 

that you take medicine, so you don’t develop TB disease. The following TB medications 

are used on their own or in combination to treat LTBI:

»

Isoniazid (INH) Rifapentine (RPT) Rifampin (RIF)

CDC and the National Tuberculosis Controllers Association recommend one of the 

following treatment options for LTBI: 

» Three months of once-weekly isoniazid plus rifapentine (3HP)

Four months of daily rifampin (4R)

Three months of daily isoniazid plus rifampin (3HR)

If none of the treatment regimens above is an option for you, there are alternative 

effective LTBI treatment regimens which include 6 or 9 months of isoniazid. When 

taking isoniazid, your doctor may have you take vitamin B6 with your medication. 

Your doctor will be able to determine which treatment option is best for your 

situation. Your treatment may have to be modified if you have had contact with 

someone whose TB disease is caused by germs that are resistant to isoniazid or 

rifampin, two of the most important medicines for treating LTBI and TB disease. This 

means that those medicines can no longer kill the TB germs.

Sometimes people are given treatment for LTBI even if their TB blood test result or TB 

skin test reaction is negative. This is often done with infants, children, and HIV-infected 

people who have recently spent time with someone with TB disease. This is because 

these groups are at very high risk of developing TB disease soon after they become 

infected with TB germs. 

Q&A ABOUT TB 13
If you start taking treatment for LTBI, you will need to see your doctor or nurse on 

a regular schedule. It is important that you take all the medicine as prescribed. The 

doctor or nurse will check on how you are doing. 

What are the side effects of medicines to treat latent 

TB infection (LTBI)? 

Most people can take their latent TB infection (LTBI) medicines without any problems; 

however, sometimes there are side effects. Some side effects are minor problems. For 

example, the rifampin or rifapentine medicine may cause orange discoloration of body 

fluids such as urine (pee), saliva, tears, or sweat, and breast milk. Orange discoloration 

of body fluids is expected and harmless. This is normal and the color may fade over 

time. The doctor or nurse may advise you not to wear soft contact lenses because they 

may get permanently stained. If you have any of these side effects, you can continue 

taking your medicine.

If you have a serious side effect, call your doctor or nurse immediately. You may be 

told to stop taking your LTBI medicines or to return to the clinic for tests. Serious side 

effects include:

» Dizziness or lightheadedness

Loss of appetite

Flu-like symptoms

Severe diarrhea or light-colored stools

Shortness of breath

Feelings of sadness or depression

Fever

Unexplained weight loss

Brown urine (color of coffee or cola)

Yellowish skin or eyes

Rash

Persistent tingling or prickling 

sensation of hands and feet 

Persistent tiredness or weakness 

lasting 3 or more days

Stomach pain 

Easy bruising or bleeding

Joint pain

Nausea

Vomiting 

Q&A ABOUT TB 14
You should provide a list of current medicines you are taking to your health care 

provider to avoid drug interactions. Some oral contraceptives (birth control pills) 

may not work as well when you take them with TB medicines. This is because the 

TB medicines can sometimes interfere with birth control pills and possibly make 

the birth control pills less effective. If you are using birth control pills, talk with your 

doctor before beginning any new medicines. More information on side effects from TB 

medicine can be found at CDC’s TB Treatment: Adverse Events page.

Warning: Drinking alcoholic beverages, such as wine, beer, or liquor, while taking TB 

medicines can be dangerous. Check with your doctor or nurse for more information.

Everyone who has LTBI needs to know the symptoms of TB disease (see page 8). If 

you develop symptoms of TB disease, you should see a doctor right away. 

People sometimes need help managing the LTBI medicine they must take. The CDC 

has developed LTBI medicine trackers to help patients organize and manage their LTBI 

medicine. On these medicine trackers, there is space to write treatment schedules, 

medication intake, and doctor/clinic contact information. There is also a checklist of 

signs and symptoms that may develop while taking LTBI medicine. 

The three medicine trackers include: 

1.

12-Dose Regimen for 

Latent TB InfectionMedication Tracker 

and Symptom 

Checklist

(available in English, 

Spanish, Tagalog, 

and Vietnamese 

languages).

2.

4 Months Daily 

Rifampin (4R) 

Regimen for 

Latent TB Infection 

Medication Tracker 

and Symptom 

Checklist

(available in English). 

3.

3 Months of Daily 

Isoniazid plus 

Rifampin (3HR) 

Regimen for 

Latent TB Infection 

Medication Tracker 

and Symptom 

Checklist

(available in English).

To download or print these materials, visit the CDC TB Education Materials page. 

To learn more about LTBI, visit these CDC webpages: 

» Treatment Regimens for LTBI

Deciding When to Treat LTBI

Treating LTBI with Short-Course Regimens

Q&A ABOUT TB 15
What if I have HIV infection?

If you have HIV infection and latent TB infection (LTBI), you need treatment as soon 

as possible to prevent TB disease. A person with HIV infection who also has untreated 

LTBI is much more likely to develop TB disease during his or her lifetime than someone 

without HIV infection. Among people with LTBI, HIV infection is the strongest known 

risk factor for progressing to TB disease. All people with HIV infection should be 

tested to find out if they have LTBI and promptly seek treatment if necessary. There 

are several effective LTBI treatment regimens available for people with HIV. 

If I was exposed to someone with TB disease, can I 

give TB to others?

If you were exposed to someone with TB disease, you may become infected with TB 

bacteria, but you would not be able to spread the bacteria to others right away. Only 

people with infectious TB disease can spread TB germs to others. Before you would 

be able to spread TB germs to others, you would have to breathe in TB germs and 

become infected. Then the germs would have to multiply in your body and cause 

infectious TB disease. At this point, you could possibly spread TB germs to others.

In most people who breathe in TB germs and become infected, the body can fight the 

germs to stop them from growing. The germs become inactive, but they remain alive in 

the body and can become active later. This is called latent TB infection (LTBI). People 

with LTBI cannot spread TB germs to others. People who have LTBI can be treated to 

prevent TB disease.

Q&A ABOUT TB 16
How is TB disease treated?

There is good news for people with TB disease! It can almost always be treated and cured 

with medicine. But the medicine must be taken as directed by your doctor or nurse.

If you have TB disease, you will need to take several different TB medicines. This is 

because there are many TB germs to be killed. Taking several TB medicines will do a 

better job of killing all the TB germs and preventing them from becoming resistant to 

the medicines. “Resistant” means that the medicine can no longer kill the TB bacteria.

The most common medicines used to treat TB 

disease are

» Isoniazid (INH)

Rifampin (RIF)

Ethambutol (EMB)

Pyrazinamide (PZA)

If you have TB disease of the lungs or 

throat, you are probably infectious. You 

need to stay home from work or school so 

that you don’t spread TB germs to other 

people. After taking your medicine for a few 

weeks, you will feel better and you might no 

longer be infectious to others. Your doctor or 

nurse will tell you when you can return to work or 

school or visit with friends.

Having TB disease should not stop you from leading a normal life. People who are no 

longer infectious or feeling sick are often able to do the same things they did before 

they had TB disease. If you take your medicines as directed by your doctor or nurse, 

they should kill all the TB germs. This will keep you from becoming sick again.

Q&A ABOUT TB 17
What are the side effects of TB disease medicines?

If you are taking medicines for TB disease, you should take them as directed by your 

doctor or nurse. The TB medicines may cause side effects. Some side effects are minor 

problems. Others are more serious. If you have a serious side effect, call your doctor 

or nurse immediately. You may be told to stop taking your TB medicines or to return 

to the clinic for tests. Serious side effects include:

» Skin rash

Blurred or changed vision

Stomach pain

Brown urine or light-colored stool

Tiredness

Fever for 3 or more days

Flu-like symptoms

Lack of appetite

Nausea

Vomiting

Yellowish skin or eyes

Dizziness

Tingling or numbness around 

the mouth

Persistent tingling sensation 

in the hands and feet

Stomach upset

Joint aches 

Easy bruising or 

bleeding

Some side effects are minor problems. For example, 

rifampin may cause orange discoloration of body 

fluids such as urine (pee), saliva, tears, or sweat, 

and breast milk. Orange discoloration of body 

fluids is expected and harmless. This is normal and 

the color may fade over time. The doctor or nurse 

may advise you not to wear soft contact lenses 

because lenses may get permanently stained. If 

you have any of these side effects, you can continue 

taking your medicine.

Medicine that is prescribed to treat TB disease may interact 

with other drugs. You should provide a list of current medicines you are taking to your 

health care provider to avoid drug interactions. 

For example, medicine for TB disease can interact with oral contraceptives (birth 

control pills) and possibly make the birth control pills less effective. If you are using 

birth control pills, ask your doctor about alternative birth control while you are taking 

TB medicines. If you are taking methadone (used to treat drug addiction) during TB 

treatment, you may have withdrawal symptoms. Your doctor or nurse may need to 

adjust your methadone dosage.

More information on side effects from TB medicine can be found at CDC’s TB 

Treatment: Adverse Events page. 

Q&A ABOUT TB 18
Why do I need to take TB medicines for so long?

TB germs die very slowly. For the treatment of latent TB 

infection (LTBI), it takes at least 3 months (and possibly 

longer depending on which medications you are on) 

to kill the TB germs. 

For TB disease, it usually takes 6 months or longer 

for the medicines to kill all the TB germs. You will 

probably start feeling well after only a few weeks 

of treatment, but beware! The TB germs are still 

alive in your body, even if you feel better. You must 

continue to take your medicines until all the TB 

germs are dead, even though you may feel better and 

have no more symptoms of TB disease.

It can be very dangerous to stop taking your medicines or not to take all your 

medicines regularly. The TB germs will grow again, and you will remain sick for a 

longer time. The TB germs may also become resistant to the medicines you are taking. 

You may need new different medicines to kill the TB germs if the old medicines no 

longer work. These new medicines must be taken for a longer time and usually have 

more serious side effects.

If you become infectious again, you could give TB germs to your family, friends, or 

anyone else who spends time with you. It is very important to take all your medicines 

as directed by your doctor or nurse.

What are multidrug-resistant TB (MDR TB) and 

extensively drug-resistant TB (XDR TB)?

Sometimes the TB germs are resistant to the medicines used to treat TB disease. This 

means that the medicine can no longer kill the TB germs. 

Multidrug-resistant TB (MDR TB) is caused by TB germs that are resistant to at least 

two of the most important TB medicines: isoniazid and rifampin. 

A more serious form of MDR TB is called extensively drug-resistant TB (XDR TB). XDR 

TB is a rare type of TB that is resistant to nearly all medicines used to treat TB disease.

If you do not take your medicines as directed by your doctor or nurse, the TB germs 

may become resistant to certain medicines. Also, people who have spent time with 

someone who is sick with MDR TB or XDR TB can become infected with these 

multidrug-resistant TB germs.

Q&A ABOUT TB 19
Drug-resistant TB is more common in people who

» Have spent time with someone with drug-resistant TB disease.

Do not take all their medicines as directed by their doctor or nurse.

Develop TB disease again after having taken TB medicines in the past.

Come from areas where drug-resistant TB is common.

People with MDR TB or XDR TB must be treated with special medicines. Treatment 

takes much longer than for regular TB and the medicines may cause more side effects. 

People with MDR TB or XDR TB are at greater risk of dying from the disease. People 

with MDR TB or XDR TB must see a TB expert who can closely observe their treatment 

to make sure it is working. 

What is directly observed therapy (DOT)?

The best way to remember to take your medicines is to get directly observed therapy 

(DOT); this is especially true for treatment of TB disease. If you get DOT, you will meet 

with a health care worker every day or several times a week. You will meet at a place 

you both agree on, or by electronic methods. Meeting in person can be at the TB clinic, 

your home or work, or any other convenient location. You will take your medicines at 

this place while the health care worker watches. Some TB programs now use electronic 

methods of DOT for both TB disease and latent TB infection (LTBI). Electronic DOT 

(eDOT) is an alternative to in-person DOT. If eDOT is available in your area and 

you qualify for eDOT, a health care worker will watch you take your TB medication 

remotely over a smartphone or other video-capable electronic device. DOT, whether 

in-person or using an electronic device, helps you remember to take your medicines 

and complete your treatment. This means you will get well as soon as possible.

The health care worker will also make sure that the TB 

medicines are working as they should. This person 

will also watch for side effects and answer any 

questions you have about TB.

Even if you are not getting DOT, you 

must be checked regularly by your 

doctor or nurse at different times 

during your treatment to make sure 

everything is going well. This will 

continue until you are cured.

Q&A ABOUT TB 20
How can I remember to take my TB medicines if I am 

not on DOT?

The only way to get well is to take your TB medicines exactly as directed by your 

doctor or nurse. This may not be easy! If you have LTBI, you will be taking your LTBI 

medicines for 3 months or longer. If you have TB disease, you will generally be taking 

medicine for 6 months or longer. 

Getting into a routine can help you remember to take your TB medicine as directed. 

Here are some ways to help you remember to take your medicines whether you are on 

LTBI medicine or TB disease medicine:

» Take your pills at the same time every day—for 

example, you can take them before eating 

breakfast, during a regular coffee break, or 

after brushing your teeth.

Ask a family member or a friend to remind 

you to take your pills.

Mark off each day on a calendar as you take 

your pills.

Put your pills in a weekly pill dispenser that you 

keep by your bed or in your purse or pocket. 

Use a medicine tracker to organize and manage your 

pills. The CDC website has printable LTBI medicine trackers available. On the LTBI 

medicine trackers, there is space to write your treatment schedule, number of 

pills to be taken per week, and doctor/clinic contact information. To download or 

print the medicine trackers, visit the CDC TB Education Materials page.

NOTE: Remember to keep all medicine out of reach of children.

If you forget to take your pills one day, skip that dose and take the next scheduled 

dose. Tell your doctor or nurse that you missed a dose. You may also call your doctor 

or nurse for instructions.

Q&A ABOUT TB 21
How can I keep from spreading TB?

The most important way to keep from spreading TB germs is for people with infectious 

TB disease to take all medicines exactly as directed by a doctor or nurse. You also 

need to keep all your clinic appointments. Your doctor or nurse needs to see how you 

are doing. This often requires another chest x-ray or a test of your sputum 

(phlegm that is coughed up from deep in the lungs). These tests will 

show whether the medicines are working. Tests also help to show 

whether you can still spread TB germs to others. Be sure to tell 

your health care provider about anything you think is wrong.

If you are sick enough with TB disease to go to a hospital, 

you may be put in a special room. These rooms use 

air vents that keep TB germs from spreading to other 

rooms. People who work in these special rooms must 

wear a special face mask to protect themselves from 

TB germs. You must stay in the room so that you will 

not spread TB germs to other people. 

If you are infectious while you are at home, there are 

things you can do to protect others near you: 

» Take your medicines as directed. This is very 

important! 

Always cover your mouth with a tissue when you cough, sneeze, or laugh. 

Put the tissue in a closed bag and throw it away. 

Separate yourself from others and avoid close contact with anyone. Sleep in a 

bedroom away from other family members. Avoid having visitors in the home.

Do not go to work or school. 

Air out your room often to the outside of the building (if it is not too cold 

outside). TB spreads in small closed spaces where air 

doesn’t move. Put a fan in your window to blow 

out (exhaust) air that may be filled with TB 

germs. If you have other windows in the closed 

room, open them too so that the fan can pull 

in fresh air. This will reduce the chances that 

TB germs will stay in the room and infect 

someone who breathes the air.

Remember, TB is spread through the air. People 

cannot get infected with TB germs through 

Q&A ABOUT TB 22
handshakes, sitting on toilet seats, or sharing dishes and utensils with someone who 

has TB.

After you take the medicines for about 2 or 3 weeks, you might no longer be able to 

spread TB germs to others. Your doctor or nurse will tell you when you can return to 

work or school or visit with friends.

Remember, you will get well only if you take your medicines exactly as directed by 

your doctor or nurse.

Think about people who may have spent time with you, such as family members, 

close friends, and coworkers. The local health department may need to test them 

for TB infection. TB is especially dangerous for children and people infected with 

HIV. If infected with TB germs, these people need medicine right away to keep from 

developing TB disease.

Additional TB Resources

For additional information about latent TB infection (LTBI) and TB disease, please 

visit the CDC TB website. Patient materials on LTBI and TB disease are also available 

in multiple languages at CDC’s TB Patient Education Materials page and Find TB 

Resources.

For information on TB patient support and outreach, visit We Are TB. CDC also 

highlights the personal experiences of people who were diagnosed and treated for 

LTBI and TB disease, as well as the work of TB control professionals. Visit the CDC TB 

personal stories page for more information.

Q&A ABOUT TB 23
Publication Number: 21-1024 

For more information

or to order educational materials about TB,

contact your local Health Department

Or visit: 

Centers for Disease Control and Prevention

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention

 @cdc_TB @CDCTB

Division of Tuberculosis Elimination

www.cdc.gov/tb